ABSTRACT
Polymyxin B, which is a last-line antibiotic for extensively drug-resistant Gram-negative bacterial infections, became available in China in Dec. 2017. As dose adjustments are based solely on clinical experience of risk toxicity, treatment failure, and emergence of resistance, there is an urgent clinical need to perform therapeutic drug monitoring (TDM) to optimize the use of polymyxin B. It is thus necessary to standardize operating procedures to ensure the accuracy of TDM and provide evidence for their rational use. We report a consensus on TDM guidelines for polymyxin B, as endorsed by the Infection and Chemotherapy Committee of the Shanghai Medical Association and the Therapeutic Drug Monitoring Committee of the Chinese Pharmacological Society. The consensus panel was composed of clinicians, pharmacists, and microbiologists from different provinces in China and Australia who made recommendations regarding target concentrations, sample collection, reporting, and explanation of TDM results. The guidelines provide the first-ever consensus on conducting TDM of polymyxin B, and are intended to guide optimal clinical use.
Subject(s)
Humans , Anti-Bacterial Agents/therapeutic use , China , Drug Monitoring/methods , Polymyxin B , Practice Guidelines as TopicABSTRACT
OBJECTIVE:To establish a method for the concentration determination of catecholamines in human urine. METH-ODS:After extracted by aluminum oxide,using 3,4-dihydroxybenzylamine as internal standard,HPLC-electrochemistry was per-formed on the column of Shim-Pack C18 with mixed solution [every 500 ml mixed solution containing ion-pairing reagents(octane sulfonate) 0.5 mmol,methanol 10 ml,0.06 mmol/L Di-n-butylamine 50 μl,sodium acetate anhydrous 2.0 g,citric acid 5.5 g, EDTA-Na2 60 mg and sodium chloride 584.4 mg,pH=3.5] at a flow rate of 0.8 ml/min,column temperature was 30 ℃,detection voltage was 750 mV,and injection volume was 40 μl. RESULTS:The linear ranges were 3.125-100 ng/ml for both norepinephrine (r=0.998 5)and epinephrine(r=0.999 2),lower limits of quantitation were 3.125 ng/ml;RSDs of within days and daytime were lower than 10%,method recoveries were 99.2%-101.6% and 98.9%-100.5%,extraction recoveries were 63.8%-66.8% and 60.5%-62.6%. CONCLUSIONS:The method shows strong specificity,high sensitivity and low detection cost,and can be used for the concentration determination of catecholamines in human urine.
ABSTRACT
Objective To investigate the effect of Salvia miltiorrhiza extracts on morphine physical dependence in mice. Methods The physical dependence model was induced by repeated sc morphine daily in mice and then withdrawal symptom was induced by ip naloxone. Different doses of S. miltiorrhiza extracts were administrated by ip during or after the induction phase of morphine dependence, and effects of S. miltiorrhiza extracts both by preventive and acute administration on naloxone-precipiated withdrawal symptom in mice were investigated. The potential physical dependence of S. miltiorrhiza extracts was studied. Results Compared to morphine model group, preventive administration of S. miltiorrhiza extracts (100—200 mg/kg) could reduce the number of naloxone-induced withdrawal jumps (P